The aim of the study was to evaluate the antidiabetic, antihyperlipidemic and antioxidant potential of the CTO and its active constituent cinnamaldehyde in STZ induced diabetes in rats. Diabetes mellitus causes a disturbance in the uptake of glucose as well as glucose metabolism. A dose of STZ as low as 50

mg/kg produces an incomplete destruction of pancreatic beta cells even though the rats become permanently diabetic [
28]. After treatment with a low dose of STZ many beta cells survive and regeneration is also possible [
29]. Hyperglycemia generates abnormally high levels of free radicals by autoxidation of glucose and protein glycation, and oxidative stress has been reported to be a positive factor of cardiovascular complications in STZ-induced diabetes mellitus [
30]. Hyperglycemia is associated with the generation of reactive oxygen species (ROS) causing oxidative damage particularly to heart, kidney, eyes, nerves, liver, small and large vessels and gastrointestinal system [
31]. The increased levels of plasma glucose in diabetic rats were lowered by CTO and cinnamaldehyde administration. The antihyperglycemic action of cinnamaldehyde results from the potentiation of insulin from existing beta cells of the islets of Langerhans [
32].
To study the effect of CTO a preliminary investigation was carried out using acute antihyperglycemic model which revealed the significant reduction in glucose level. Therefore further chronic antihyperglycemic model for a period of 28

days to study the effect on various other parameters viz. insulin level, liver glycogen content, glycosylated hemoglobin, total plasma cholesterol, triglyceride and antioxidant parameters were estimated for all treated groups and compared against diabetic control group. The plasma glucose lowering activity was compared with glibenclamide, a standard hypoglycemic drug. Glibenclamide has been used for many years to treat diabetes, to stimulate insulin secretion from pancreatic beta cells [
33]. From the results of the present study, it appears that still insulin producing cells are functioning and the stimulation of insulin release could be responsible for most of the metabolic effects. It may be suggested that the mechanism of action of CTO is similar to glibenclamide. The glucose lowering activity of CTO may be related to both pancreatic (enhancement of insulin secretion) and extra pancreatic (peripheral utilization of glucose) mechanism. The hyperglycemic activity was almost similar to cinnamaldehyde thereby the major constituent responsible for this activity of CTO may be cinnamaldehyde.
An increase in the level of glycosylated hemoglobin (HbA1c) in the diabetic control group of rats is due to the presence of large amount of blood glucose which reacts with hemoglobin to form glycosylated hemoglobin [
34]. Oxidative stress increases due to the activation of transcription factors, advanced glycated end products (AGEs), and protein kinase C. If diabetes is persistent for long time, the glycosylated hemoglobin is found to increase [
35]. The level of HbA
1C was decreased after the administration of CTO and its main constituent cinnamaldehyde as compared to diabetic control group. The effect of cinnamon in clinical study is also reported in which the mean HbA1c was significantly decreased (P < 0.005) in the cinnamon group (8.22% to 7.86%) compared with placebo group (8.55% to 8.68%). Thus the Cinnamon supplementation could be considered as an additional dietary supplement option to regulate blood glucose level along with conventional medications to treat type 2 diabetes mellitus [
36]. In diabetes mellitus, the loss of body weight is caused by increase in muscle wasting and catabolism of fat and proteins [
37]. Due to insulin deficiency protein content is decreased in muscular tissue by proteolysis [
38]. A decrease in body weight was registered in case of diabetic control group rats while in tested groups the weight loss was reversed. Fatty acid mobilisation from adipose tissue is sensitive to insulin. Insulin’s most potent action is the suppression of adipose tissue lipolysis [
39]. A rise in plasma insulin concentration of only 5

IU/ml inhibits lipolysis by 50%, whereas a reduction in basal insulin levels result in a marked acceleration of lipolysis [
40]. We demonstrated that CTO increased plasma insulin concentrations in diabetic rats. Insulin levels higher than those of the control group may result in inhibition of lipolysis and decreased plasma triglyceride and cholesterol levels. Some studies suggest that the antihyperglycemic action of traditional antidiabetic plant extracts may be due in part to decreased glucose absorption in vivo [
41]. This mechanistic explanation may also apply to the actions of CTO in lowering the triglyceride and cholesterol level.
The conversion of glucose to glycogen in the liver cells is dependent on the extracellular glucose concentration and on the availability of insulin which stimulates glycogen synthesis over a wide range of glucose concentration [
35]. Diabetes reduces activity of glycogen synthase thereby affecting the glycogen storage and synthesis in rat liver and skeletal muscle [
27]. Oral administration of CTO 200

mg/kg body weight significantly increased hepatic glycogen levels in diabetic rats possibly because of the reactivation of the glycogen synthase system as a result of increased insulin secretion. In the clinical study the use of species of cinnamon (
Cinnamomum zeylanicum) showed a beneficial effect on glycemic control (both HbA1c and Fating plasma glucose) and the short term (<4

months) effects of the use of cinnamon on glycaemic control looks promising [
42]. The effect of
Cinnamomum zeylanicum is also reported on gastric emptying, arterial stiffness, postprandial lipemia, glycemia, and appetite responses to high-fat breakfast [
43]. Further the work can be explored for mechanism of action.